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Middle Segment Pancreatectomy: A Useful Tool in the Management of Pancreatic Neoplasms

  • Published:
Journal of Gastrointestinal Surgery

An Erratum to this article was published on 25 May 2007

Abstract

Small, benign, or low-grade malignant tumors located in the neck of the pancreas are usually treated with enucleation. However, if enucleation is too risky because of possible damage of the main pancreatic duct, standard pancreatic resections are performed. Such operations can lead to impaired long-term exocrine–endocrine function. Middle segment pancreatectomy consists of a limited resection of the midportion of the pancreas and can be performed in selected patients affected by tumors of the pancreatic neck. Middle segment pancreatectomy is a safe and feasible procedure for treating tumors of the pancreatic neck; in experienced hands it is associated with no mortality but with high morbidity, even if the rate of “clinical” pancreatic fistula is about 20%. Moreover, it allows a surgeon to preserve pancreatic parenchyma and consequently long-term endocrine and exocrine pancreatic function.

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References

  1. Iacono C, Bortolasi L, Serio G. Is there a place for central pancreatectomy in pancreatic surgery? J Gastrointest Surg 1998;2:509–517.

    Article  PubMed  CAS  Google Scholar 

  2. Warshaw AL, Rattner DW, Fernandez-del Castillo C, Z’graggen K. Middle segment pancreatectomy. Arch Surg 1998;133:327–331.

    Article  PubMed  CAS  Google Scholar 

  3. Sperti C, Pasquali C, Ferronato A, Pedrazzoli S. Median pancreatectomy for tumours of the neck and body of the pancreas. J Am Coll Surg 2000;190:711–716.

    Article  PubMed  CAS  Google Scholar 

  4. Iacono C, Bortolasi L, Serio G. Indications and technique of central pancreatectomy—early and late results. Langenbecks Arch Surg 2005;390:266–271.

    Article  PubMed  Google Scholar 

  5. Aranha GV, Shoup M. Nonstandard pancreatic resections for unusual lesions. Am J Surg 2005;189:223–228.

    Article  PubMed  Google Scholar 

  6. Christein JD, Smoot RL, Farnell MB. Central pancreatectomy: a technique for the resection of pancreatic neck lesions. Arch Surg 2006;141:293–299.

    Article  PubMed  Google Scholar 

  7. Letton AH, Wilson JP. Traumatic severance of pancreas treated by Roux-Y anastomosis. Surg Gynecol Obstet 1959;109:473–478.

    PubMed  CAS  Google Scholar 

  8. Dagradi A, Serio G. Pancreatectomia intermedia. In: Enciclopedia medica italiana. Pancreas, vol. XI. Florence: USES Ed. Scientifiche, 1984, pp 850–851.

  9. Fagniez PL, Kracht M, Rotman N. Limited conservative pancreatectomy for benign tumours: a new technical approach. Br J Surg 1988;75:719.

    Article  PubMed  CAS  Google Scholar 

  10. Rotman N, Sastre B, Fagniez P. Median pancreatectomy for tumours of the neck of the pancreas. Surgery 1993;113:532–535.

    PubMed  CAS  Google Scholar 

  11. Ikeda S, Matsumoto S, Maeshiro K, Miyazaki R, Okamoto K, Yasunami Y. Segmental pancreatectomy for the diagnosis and treatment of small lesions in the neck or body of the pancreas. Hepatogastroenterology 1995;42:730–733.

    PubMed  CAS  Google Scholar 

  12. Asanuma Y, Koyama K, Saito K, Tanaka J. An appraisal of segmental pancreatectomy for benign tumors of the pancreatic body: a report of two cases. Surg Today 1993;23:733–736.

    Article  PubMed  CAS  Google Scholar 

  13. Aranha GV. Central (middle segment) pancreatectomy: a suitable operation for small lesions of the neck of the pancreas. Hepatogastroenterology 2002;49:1713–1715.

    PubMed  Google Scholar 

  14. Chan C, Podgaetz E, Torres-Villalobos G, Anthon FJ, Herrera MF. Central pancreatectomy as an indication for various benign pancreatic tumors. Am Surg 2004;70:304–306.

    PubMed  Google Scholar 

  15. Christein JD, Kim AW, Golshan MA, Maxhimer J, Deziel DJ, Prinz RA. Central pancreatectomy for the resection of benign or low malignant potential neoplasms. World J Surg 2003;27:595–598.

    Article  PubMed  Google Scholar 

  16. Kim AW, Cacciopo JR, Golshan MA, Templeton AC, Prinz RA. Pancreatic epithelial cyst in an adult treated by central pancreatectomy. J Gastrointest Surg 2001;5:634–637.

    Article  PubMed  CAS  Google Scholar 

  17. Molino D, Perrotti P, Antropoli C, Bottino V, Napoli V, Fioretto R. Central segmental pancreatectomy in benign and borderline neoplasms of the pancreatic isthmus and body. Chir Ital 2001;53:319–325.

    PubMed  CAS  Google Scholar 

  18. Celis J, Berrospi F, Ruiz E, Payet E, Luque C. Central pancreatectomy for tumors of the neck and body of the pancreas. J Surg Oncol 2001;77:132–135.

    Article  PubMed  CAS  Google Scholar 

  19. Takada T, Aman H, Ammorsi BJ. A novel technique for multiple pancreatectomies: removal of uncinate process of the pancreas combined with medial pancreatectomy. J Hepatobiliary Pancreat Surg 2000;7:49–51.

    Article  PubMed  CAS  Google Scholar 

  20. Goldstein MJ, Toman J, Chabot JA. Pancreaticogastrostomy: a novel application after central pancreatectomy. J Am Coll Surg 2004;198:871–876.

    Article  PubMed  Google Scholar 

  21. Efron DT, Lillemoe KD, Cameron JL, Yeo CJ. Central pancreatectomy with pancreaticogastrostomy for benign pancreatic pathology. J Gastrointest Surg 2004;8:532–538.

    Article  PubMed  Google Scholar 

  22. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M, International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005;138:8–13.

    Article  PubMed  Google Scholar 

  23. Bassi C, Falconi M, Salvia R, Mascetta G, Molinari E, Pederzoli P. Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients. Dig Surg 2001;18:453–457.

    Article  PubMed  CAS  Google Scholar 

  24. Balcom JH 4th, Rattner DW, Warshaw AL, Chang Y, Fernandez-del Castillo C. Ten year experience with 733 pancreatic resection: changing indications, older patients and decreasing length of hospitalization. Arch Surg 2001;136:391–398.

    Article  PubMed  Google Scholar 

  25. Kahl S, Malfertheiner P. Exocrine and endocrine pancreatic insufficiency after pancreatic surgery. Best Pract Res Clin Gastroenterol 2004;18:947–955.

    Article  PubMed  Google Scholar 

  26. Ghaneh P, Neoptolemos JP. Exocrine pancreatic function following pancreatectomy. Ann N Y Acad Sci 1999;880:308–318.

    Article  PubMed  CAS  Google Scholar 

  27. Jalleh RP, Williamson RC. Pancreatic exocrine and endocrine function after operations for chronic pancreatitis. Ann Surg 1992;216:656–662.

    Article  PubMed  CAS  Google Scholar 

  28. Wittingen J, Frey CF. Islet concentration in the head, body, tail and uncinate process of the pancreas. Ann Surg 1974;179:412–414.

    Article  PubMed  CAS  Google Scholar 

  29. Sato N, Yamaguchi K, Yokohata K, et al. Short-term and long-term pancreatic exocrine and endocrine functions after pancreatectomy. Dig Dis Sci 1998;43:2616–2621.

    Article  PubMed  CAS  Google Scholar 

  30. Kendall DM, Sutherland DE, Najarian JS, Goetz FC, Robertson RP. Effects of hemipancreatectomy on insulin secretion and glucose tolerance in healthy humans. N Engl J Med 1990;322:898–903.

    Article  PubMed  CAS  Google Scholar 

  31. Seaquist ER, Kahn SE, Clark PM, Hales CN, Porte D Jr, Robertson RP. Hyperproinsulinemia is associated with increased beta cell demand after hemipancreatectomy in humans. J Clin Invest 1996;97:455–460.

    Article  PubMed  CAS  Google Scholar 

  32. Falconi M, Mantovani W, Frigerio I, et al. Intermediate resection and distal pancreatectomy for benign neoplasms of the pancreas: comparison of postoperative complications and costs. Chir Ital 2001;53:467–474.

    PubMed  CAS  Google Scholar 

  33. Hines OJ, Reber HA. Median pancreatectomy: do the risk justify the effort? J Am Coll Surg 2000;190:715–716.

    Article  PubMed  CAS  Google Scholar 

  34. Sauvanet A, Partensky C, Sastre B, et al. Medial pancreatectomy: a multi-institutional retrospective study of 53 patients by the French Pancreas Club. Surgery 2002;132:836–843.

    Article  PubMed  Google Scholar 

  35. Bassi C, Falconi M, Molinari E, et al. Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study. Ann Surg 2005;242:767–771.

    Article  PubMed  Google Scholar 

  36. Bassi C, Butturini G, Falconi M, et al. Prospective randomized pilot study of management of the pancreatic stump following distal resection. HPB 2000;2:203–207.

    Google Scholar 

  37. Bassi C, Falconi M, Molinari E, et al. Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial. Surgery 2003;134:766–770.

    Article  PubMed  Google Scholar 

  38. Ziemski JM, Rudowski WJ, Jaskowiak W, Rusiniak L, Scharf R. Evaluation of early postsplenectomy complications. Surg Gynecol Obstet 1987;165:507–514.

    PubMed  CAS  Google Scholar 

  39. Lynch AM, Kapila R. Overwhelming postsplenectomy infection. Infect Dis Clin North Am 1996;10:693–707.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Chirurgia Generale B, Policlinico “GB Rossi”, University of Verona, Piazzale L.A. Scuro 10, Verona, 37134, Italy

    Claudio Bassi

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  1. Claudio Bassi
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Correspondence to Claudio Bassi.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s11605-007-0179-y.

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Bassi, C. Middle Segment Pancreatectomy: A Useful Tool in the Management of Pancreatic Neoplasms. J Gastrointest Surg 11, 421–424 (2007). https://doi.org/10.1007/s11605-007-0129-8

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  • DOI: https://doi.org/10.1007/s11605-007-0129-8

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